A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

Hold the medication and notify the HCP

Administer the medication as ordered.

Prepare to administer vitamin K (AquaMephyton).

Assess the client for abnormal bleeding.

Fat embolism

Answer and Explanation

The Correct Answer is B

A. Hold the medication and notify the HCP: This is unnecessary. An INR of 2.7 is within the therapeutic range for a client with a mechanical valve replacement (2.5 to 3.5). No intervention is required.

B. Administer the medication as ordered: The INR of 2.7 is within the desired therapeutic range for clients on warfarin with mechanical valve replacements, so the nurse should proceed with the prescribed dose.

C. Prepare to administer vitamin K (AquaMephyton): Vitamin K is used to reverse the effects of warfarin if the INR is too high (usually greater than 5).

D. Assess the client for abnormal bleeding: While important, this is not the first action. The INR is within the therapeutic range, so the priority is to administer the medication.

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Correct Answer is B

Explanation

A. Suppresses ectopic ventricular sites: Atropine primarily increases heart rate; it does not directly suppress ectopic ventricular activity.

B. Increases SA node automaticity: Atropine blocks the parasympathetic nervous system, increasing SA node activity and heart rate in cases of bradycardia or asystole.

C. Increases myocardial contractility: This effect is more related to drugs like inotropes (e.g., dopamine), not atropine.

D. Decreases AV node conduction: Atropine actually increases conduction through the AV node by blocking vagal stimulation.

A. To increase hydration B. To control symptoms C. To promote nutrition D. To limit environmental hazards

Correct Answer is B

Explanation

A. To increase hydration: This is not a priority in terminal care. In fact, increasing hydration can be uncomfortable for dying patients who are often unable to process fluids effectively.

B. To control symptoms: The primary focus in end-of-life care is to manage symptoms, such as pain, difficulty breathing, and anxiety, to ensure the patient is as comfortable as possible.

C. To promote nutrition: At the end of life, promoting nutrition is usually not the priority, as the client may no longer desire food and may be unable to tolerate it.

D. To limit environmental hazards: While important, it is not the priority in terminal care. The focus should be on comfort and symptom control.

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A nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's INR is 2.7. Which action should the nurse implement?

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